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Electrical Stimulation Versus Voluntary Exercise in Strengthening Thigh Musculature After Anterior Cruciate Ligament Surgery

A. Delitto, MHS, is Instructor, Program in Physical Therapy, Washington University Medical School, and Consulting Physical Therapist, Irene Walter Johnson Rehabilitation Institute, PO Box 8083, 660 S Euclid Ave, St. Louis, MO 63110 (USA).
S. Rose, PhD, is Director and Associate Professor, Program in Physical Therapy, Washington University Medical School, and Director, Department of Physical Therapy, Irene Walter Johnson Rehabilitation Institute.
J. McKowen, BS, is Staff Physical Therapist, Irene Walter Johnson Rehabilitation Institute.
J. Thomas, BS, is Staff Physical Therapist, Irene Walter Johnson Rehabilitation Institute.
R. Lehman, MD, is Director, Sports Medicine Physical Performance and Rehabilitation Center, 533 Couch St, St. Louis, MO 63122.
R. Shively, MD, is Assistant Professor, Division of Orthopedic Surgery, Department of Surgery, Washington University Medical School.

Twenty patients who had undergone anterior cruciate ligament reconstructive surgery were placed randomly and independently in an Electrical Stimulation Group (n = 10) or Voluntary Exercise Group (n = 10) to compare the effectiveness of these two muscle-strengthening protocols. Patients in both groups used simultaneous contraction of quadriceps femoris and hamstring muscles during a training regimen that consisted of either voluntary exercise or electrical stimulation trials five days a week for a three-week period within the first six postoperative weeks. After patients completed the training regimen, bilateral maximal isometric measurements of gravity-corrected knee extension and flexion torque were obtained for both groups and percentages were calculated. Results showed that patients in the Electrical Stimulation Group finished the three-week training regimen with higher percentages of both extension and flexion torque when compared with patients in the Voluntary Exercise Group (extension: t = 4.35, p < .05; flexion; t = 6.64, p < .05). These results indicate that patients in an electrical stimulation regimen can achieve higher individual thigh musculature strength gains than patients in a voluntary exercise regimen when simultaneous contraction of thigh muscles is prescribed during an early phase of postoperative rehabilitation.

Key Words: Electrotherapy, electrical stimulation • Knee • Ligaments • Muscle performance, lower extremity

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